Carol Lake, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R101279 Issued in MD

Practice address

430 S Broadway
Baltimore, MD 21231-2409

Phone

(443) 825-3450

NPI assigned

Sep 16, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Carol Wilkes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1891028346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 S BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212312409",
            "telephone_number": "443-825-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 S BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212312409",
            "telephone_number": "443-825-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R101279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "WILKES",
            "prefix": "MS.",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Veronika Laird
• Mindy L Lais, PSY.D.
• Shoghag Lajinian, M.D.
• Edward Gerard Lakatta, M.D.
• Lauren Shirin Lakdawala, PHARMD
• Joseph Lake, CRNA
• Troi Lake, MD
• Barbara Lakis, PT
• Balamurugan Lakshmanan, M.D.
• Brajesh Kumar Lal, M.D.

• Family Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.